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Medical Home Access and Health Care Use and Expenditures Among Children With Special Health Care Needs.
MedLine Citation:
PMID:  22147757     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To test associations between having a medical home and health services use and expenditures among US children with special health care needs (CSHCN). DESIGN: Cross-sectional analysis. SETTING: The 2003-2008 Medical Expenditure Panel Surveys. PARTICIPANTS: A total of 9816 CSHCN up to 17 years, including 1056 with a functional or sensory limitation and 8760 without a limitation. Main Exposure  Parent or caregiver report of CSHCN having a medical home. MAIN OUTCOME MEASURES: We examined CSHCN's annual use of outpatient, inpatient, emergency department, and dental visits, and annual outpatient, inpatient, emergency department, prescription medication, dental, and other health care expenditures. RESULTS: CSHCN with a medical home had 14% more dental visits compared with CSHCN without a medical home (incidence rate ratio [IRR], 1.14; 95% CI, 1.03-1.25); this finding is significant for CSHCN without limitations but not for those with limitations. The medical home was associated with greater odds of incurring total, outpatient, prescription medication, and dental expenditures (odds ratio range, 1.25-1.92). Among CSHCN with a limitation, children with a medical home had lower annual inpatient expenditures compared with those without a medical home (mean, -$968; 95% CI, -$121 to -$1928), and among CSHCN without a limitation, children with a medical home had higher annual prescription medication expenditures compared with those without a medical home (mean, $87; 95% CI, $22-$153). CONCLUSIONS: There were few differences in annual health services use and expenditures between CSHCN with and without a medical home. However, the medical home may be associated with lower inpatient expenditures and higher prescription medication expenditures within subgroups of CSHCN.
Authors:
Melissa A Romaire; Janice F Bell; David C Grossman
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-5
Journal Detail:
Title:  Archives of pediatrics & adolescent medicine     Volume:  -     ISSN:  1538-3628     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9422751     Medline TA:  Arch Pediatr Adolesc Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
School of Public Health (Drs Romaire, Bell, and Grossman), and Department of Pediatrics (Dr Grossman), University of Washington, and Group Health Research Institute (Dr Grossman), Seattle.
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